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Factors Associated With Seizure Onset in Children With Autism Spectrum Disorder

BACKGROUND AND OBJECTIVES:

Children with autism spectrum disorder (ASD) have a higher prevalence of epilepsy compared with general populations. In this pilot study, we prospectively identified baseline risk factors for the development of seizures in individuals with ASD and also identified characteristics sensitive to seizure onset up to 6 years after enrollment in the Autism Speaks Autism Treatment Network.

METHODS:

Children with ASD and no history of seizures at baseline who either experienced onset of seizures after enrollment in the Autism Treatment Network or remained seizure free were included in the analysis.

RESULTS:

Among 472 qualifying children, 22 (4.7%) experienced onset of seizures after enrollment. Individuals who developed seizures after enrollment exhibited lower scores at baseline on all domains of the Vineland Adaptive Behavior Scales, greater hyperactivity on the Aberrant Behavior Checklist (25.4 ± 11.8 vs 19.2 ± 11.1; P = .018), and lower physical quality of life scores on the Pediatric Quality of Life Inventory (60.1 ± 24.2 vs 76.0 ± 18.2; P < .001). Comparing change in scores from entry to call-back, adjusting for age, sex, length of follow-up, and baseline Vineland II composite score, individuals who developed seizures experienced declines in daily living skills (–8.38; 95% confidence interval –14.50 to –2.50; P = .005). Adjusting for baseline age, sex, and length of follow-up, baseline Vineland II composite score was predictive of seizure development (risk ratio = 0.95 per unit Vineland II composite score, 95% confidence interval 0.92 to 0.99; P = .007).

CONCLUSIONS:

Individuals with ASD at risk for seizures exhibited changes in adaptive functioning and behavior.




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Therapy and Psychotropic Medication Use in Young Children With Autism Spectrum Disorder

BACKGROUND AND OBJECTIVES:

Guidelines suggest young children with autism spectrum disorder (ASD) receive intensive nonpharmacologic interventions. Additionally, associated symptoms may be treated with psychotropic medications. Actual intervention use by young children has not been well characterized. Our aim in this study was to describe interventions received by young children (3–6 years old) with ASD. The association with sociodemographic factors was also explored.

METHODS:

Data were analyzed from the Autism Speaks Autism Treatment Network (AS-ATN), a research registry of children with ASD from 17 sites in the United States and Canada. AS-ATN participants receive a diagnostic evaluation and treatment recommendations. Parents report intervention use at follow-up visits. At follow-up, 805 participants had data available about therapies received, and 613 had data available about medications received.

RESULTS:

The median total hours per week of therapy was 5.5 hours (interquartile range 2.0–15.0), and only 33.4% of participants were reported to be getting behaviorally based therapies. A univariate analysis and a multiple regression model predicting total therapy time showed that a diagnosis of ASD before enrollment in the AS-ATN was a significant predictor. Additionally, 16.3% of participants were on ≥1 psychotropic medication. A univariate analysis and a multiple logistic model predicting psychotropic medication use showed site region as a significant predictor.

CONCLUSIONS:

Relatively few young children with ASD are receiving behavioral therapies or total therapy hours at the recommended intensity. There is regional variability in psychotropic medication use. Further research is needed to improve access to evidence-based treatments for young children with ASD.




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Patient- and Family-Centered Care in the Emergency Department for Children With Autism

BACKGROUND:

Emergency department (ED) care processes and environments impose unique challenges for children with autism spectrum disorder (ASD). The implementation of patient- and family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how elements of PFCC were experienced and applied relative to ED care for children with ASD.

METHODS:

Qualitative interviews were conducted with parents and ED service providers, drawing on a grounded theory approach. Interviews were audio recorded, transcribed verbatim, and analyzed by using established constant comparison methods. Data were reviewed to appraise the reported presence or absence of PFCC components.

RESULTS:

Fifty-three stakeholders (31 parents of children with ASD and 22 ED service providers) participated in interviews. Results revealed the value of PFCC in autism-based ED care. Helpful attributes of care were a person-centered approach, staff knowledge about ASD, consultation with parents, and a child-focused environment. Conversely, a lack of staff knowledge and/or experience in ASD, inattention to parent expertise, insufficient communication, insufficient family orientation to the ED, an inaccessible environment, insufficient support, a lack of resources, and system rigidities were identified to impede the experience of care.

CONCLUSIONS:

Findings amplify PFCC as integral to effectively serving children with ASD and their families in the ED. Resources that specifically nurture PFCC emerge as practice and program priorities.




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Disparities in Service Use Among Children With Autism: A Systematic Review

CONTEXT:

Research reveals racial, ethnic, and socioeconomic disparities in autism diagnosis; there is limited information on potential disparities related to other dimensions of services.

OBJECTIVE:

We reviewed evidence related to disparities in service use, intervention effectiveness, and quality of care provided to children with autism by race, ethnicity, and/or socioeconomic status.

DATA SOURCES:

Medline, PsychInfo, Educational Resources Informational Clearinghouse, and the Cumulative Index to Nursing and Allied Health Literature were searched by using a combination of Medical Subject Headings terms and keywords related to autism, disparities, treatment, and services.

STUDY SELECTION:

Included studies addressed at least one key question and met eligibility criteria.

DATA EXTRACTION:

Two authors reviewed the titles and abstracts of articles and reviewed the full text of potentially relevant articles. Authors extracted information from articles that were deemed appropriate.

RESULTS:

Treatment disparities exist for access to care, referral frequency, number of service hours, and proportion of unmet service needs. Evidence revealed that racial and ethnic minority groups and children from low-income families have less access to acute care, specialized services, educational services, and community services compared with higher-income and white families. We found no studies in which differences in intervention effectiveness were examined. Several studies revealed disparities such that African American and Hispanic families and those from low-income households reported lower quality of care.

LIMITATIONS:

The body of literature on this topic is small; hence it served as a limitation to this review.

CONCLUSIONS:

The documented disparities in access and quality of care may further identify groups in need of outreach, care coordination, and/or other interventions.




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The Autism Treatment Network: Bringing Best Practices to All Children With Autism

The Autism Treatment Network and Autism Intervention Research Network on Physical Health were established in 2008 with goals of improving understanding of the medical aspects of autism spectrum disorders. Over the past decade, the combined network has conducted >2 dozen clinical studies, established clinical pathways for best practice, developed tool kits for professionals and families to support better care, and disseminated these works through numerous presentations at scientific meetings and publications in medical journals. As the joint network enters its second decade continuing this work, it is undergoing a transformation to increase these activities and accelerate their incorporation into clinical care at the primary care and specialty care levels. In this article, we describe the past accomplishments and present activities. We also outline planned undertakings such as the establishment of the Autism Learning Health Network, the increasing role of family members as co-producers of the work of the network, the growth of clinical trials activities with funding from foundations and industry, and expansion of work with primary care practices and autism specialty centers. We also discuss the challenges of supporting network activities and potential solutions to sustain the network.




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Maternal and Child Health Bureaus Autism Research Program

OBJECTIVES:

To provide an overview and quantitatively demonstrate the reach of the Health Resources and Services Administration’s Maternal and Child Health Bureau autism research program.

METHODS:

We reviewed program reports and internal data from 59 autism research grantees. The US federal Interagency Autism Coordinating Committee’s strategic plan questions were used as a framework to highlight the contributions of the autism research program in advancing the field.

RESULTS:

The autism research program grantees advance research in several ways. Grantees have strengthened the evidence for autism interventions by conducting 89 studies at 79 distinct research sites. A total of 212 708 participants have enrolled in autism research program studies and 361 researchers have contributed to furthering autism research. The program addresses topics that align with the majority of the Interagency Autism Coordinating Committee’s priority topic areas, including advancements in treatments and interventions, services and supports, and identifying risk factors. Grantee products include 387 peer-reviewed publications, 19 tools, and 13 practice guidelines for improving care and intervention practices.

CONCLUSIONS:

The autism research program has contributed to medical advances in research, leveraged innovative training platforms to provide specialized training, and provided access to health services through research-based screening and diagnostic procedures. Autism research program studies have contributed to the development of evidence-based practice guidelines, informed policy guidelines, and quality improvement efforts to bolster advancements in the field. Although disparities still exist, the Health Resources and Services Administration’s Maternal and Child Health Bureau can reduce gaps in screening and diagnosis by targeting interventions to underserved populations including minority and rural communities.




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The Costs and Benefits of Regionalized Care for Children




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Growing Evidence for Successful Care Management in Children With Medical Complexity




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Red Cell Transfusion and Thrombotic Risk in Children




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Eosinophilic Pneumonia and Lymphadenopathy Associated With Vaping and Tetrahydrocannabinol Use

Idiopathic acute eosinophilic pneumonia is a rare and potentially life-threatening condition that is defined by bilateral pulmonary infiltrates and fever in the presence of pulmonary eosinophilia. It often presents acutely in previously healthy individuals and can be difficult to distinguish from infectious pneumonia. Although the exact etiology of idiopathic acute eosinophilic pneumonia remains unknown, an acute hypersensitivity reaction to an inhaled antigen is suggested, which is further supported by recent public health risks of vaping (electronic cigarette) use and the development of lung disease. In this case, a patient with a year-long history of vaping in conjunction with tetrahydrocannabinol cartridge use who was diagnosed with idiopathic acute eosinophilic pneumonia with associated bilateral hilar lymphadenopathy is described.




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The History of the Personal Belief Exemption




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OM sows seeds at National Ploughing Championships

OM Ireland's community outreach team participates in one of Ireland's biggest events: the 2011 National Ploughing Championships in Athy, Co. Kildare from 20 -22 September.




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Light shines on Irish horse fair

An outreach team learns the value of sharing their personal testimonies and what a little light can do to a community.




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Donkey teaches Irish children true meaning of Christmas

The Creative Arts team perform their Christmas show for school children all over Ireland in the course of three weeks.




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Children encouraged to 'Pass the Parcel'

To present the true meaning of Christmas, OM Ireland’s creative arts team performs a multimedia production in schools, churches and community centres around Ireland.




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Ploughing with the Big Red Bus

After years of the team dreaming, the Big Red Bus finally joins the National Ploughing Championships during a windstorm.




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Reaching the community

The Bailie family serve with their local church as part of OM in Ireland's Philippian Project.




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At the Chief's feet

A worker shares a story about becoming the fragrance of Christ as she and a team member wash the feet of a local village chief.




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Let there be chickens

OM Namibia partners with local pastor in community business effort raising chickens.




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Forest Hill Fun Day

Forest Hill is a town in the Lockyer Valley infamous for being one of three towns in Queensland completely evacuated during last January's floods. About 300 people were airlifted by helicopters to higher ground leaving behind homes, all belongings and even pets. They had no idea what would come of those things left behind. OM Australia suggested the idea as a good way to utilise some funds donated to flood recovery. The Forest Hill Development Association Inc. in conjunction with the Laidley Baptist Church used this money to put on a community fair. It was an opportunity for the town to say thank you to those who had helped with the flood clean up and also to build the morale of the community. At the same time the involvement of the Church would raise the profile of Christ in the community.




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No such thing as retirement

After 23 years of reaching out to refugees and immigrants in Germany, one OM couple have relocated to Canada to continue their ministry.




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Sport & discipleship - Igor's story

Sport creates a platform for evangelism and discipleship in Ukraine.




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Extreme Leadership Training Creates Unity

Extreme Leadership Training camps create unity in Ukraine.




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Teaching spiritual and physical fitness

An OM Ukraine sports team member helps young Ukrainian women gain a healthier understanding and appreciation of the bodies God gave them.




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‘Now is the time for the Church to shine’

An OM Ukraine leader reports that amidst ongoing conflict, deep changes are taking place that OM Ukraine expects will lead to spiritual harvest.




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Hope for children with autism

OM Ukraine Odessa invites children with autism and their families to a two-day summer camp.




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Church planting within the conflict zone

A report of results: OM has been supporting church planting efforts and training local missionary teams to plant churches nearby and within the conflict area.




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Odessa orphans: his heart's home

Long-term follower of Jesus, Nikolay, stepped out in faith to help orphans in Ukraine, and partners with OM in this ministry to children.




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Reaching the next generation

Sunday School isn't just for Sundays anymore - it can be on any given day of the week in Ukraine.




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Reaching the tribe

Balboa, Panama :: Logos Hope's volunteers visit a Panamanian tribe on an isolated island which is being reached by the gospel.




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This is how God showed His power

Martin (Argentina) wasn’t sure whether short-term missions was his idea or God’s—until he went on an unforgettable 14-day outreach to Panama.




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Young, achingly hip and social media savvy: welcome to the world of Scotland's fashion influencers

Founded by Wendy H Gilmour in 2011, Thankfifi began as a fashion blog and has since grown to cover lifestyle, travel and interiors.




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Be bold this Valentine's Day in colourful lingerie

Compiled by: Antigoni Markitani




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Mary Quant Exhibition opens at the V&A in London

Words: Abbie Lyall




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Leonard Cheshire Disability host Fashion Show in Glasgow

Words: Abbie Lyall




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Fin24.com | MONEY CLINIC: Which debt should I pay off first in order to improve my credit score?

A Fin24 user wants to know whether paying off a car loan or credit card will make her credit score 'look better.'




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Fin24.com | MONEY CLINIC: I'm retiring later this year. Where can I invest my R700 000 pension?

A Fin24 user set to retire in August this year is looking at options on where he can invest his pension payout.




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"There are a lot worse things to be getting angry at than me." The Ellie Harrison effect

Nearly four years on from the day when Ellie Harrison's chips caused a national outcry, the artist is back to tell us more about why she did it – and how she survived that year in Glasgow in the media firing-line




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Back to the future: how Vixy Rae is breathing new life into tartan and tweed from inside Edinburgh's oldest tailor

IT’S not everyone who’s given the chance to design their own tartan so when the opportunity arose, Vixy Rae didn’t need to give it a second thought.




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Get your coat.... GANT keeping you warm this Winter

SPONSORED EDITORIAL




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The height of fashion… a catwalk show above Everest Base Camp

It was the highest catwalk show on earth, 300 metres above Everest Base Camp - and the Herald was the only paper in Britain to have a front row seat.




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Jamie Murray: Tennis player on his style makeover

WHEN you are a 6ft 3in tall, world-class tennis player with long arms, broad shoulders and a slim torso, buying off the peg is far from easy.




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Fashion: From old classics to new twists - How this year is doing trench coats

This season's colours and cuts mix up the wardrobe-staple trench, says Prudence Wade.




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Fin24.com | Mind the gap: The Mboweni-Patel policy schism runs deep

SA faces its gravest test in over 70 years, to rebuild an economy that was already in a protracted slump after the ravages of the Covid-19 pandemic. Yet, one could be forgiven for believing there's a wedge between the state's main actors tasked with the job of resurrecting a country that may see its jobless rate rise as high as 50%.




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Fin24.com | Canada loses most jobs ever, unemployment hits 13%

Canada shed three million jobs in the last two months due to the coronavirus lockdown, causing the unemployment rate to shoot up to 13% in April, the government reported Friday.




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When the Rubber Hits the Road

Profile of a veteran driver with OM EAST




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Schoolbags for children in Muslim villages

OM EAST, in partnership with OM Bosnia, is getting ready for their annual Schoolbags Project in north-west Bosnia-Herzegovina this summer.




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The hidden pearl

Jesus came to find us, like the merchant looking for fine pearls.




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Students equipped for His work

On 26 June, students from Austria Training Centre’s first year completed training in church planting, evangelism and discipleship.




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Reaching out to the world next door

One team member's impressions from the 2015 Salamu Aleikum outreach to Muslim tourists in Zell am See.